Alternative treatments

It is important to understand and consider all factors — including additional costs — as you discuss treatment options with your provider. Many people are able to prevent disability and surgery with a well-designed treatment program, including medications, exercise and physical therapy when needed.

Lifestyle changes

Regular exercise is important to keep the joints mobile. People who are overweight should lose weight, especially when arthritis affects the lower back, knees and legs. Consult a registered dietitian who can help you plan a healthy weight-loss program.

Cognitive behavior therapy

Research sponsored by the National Institutes of Health has found that cognitive behavioral therapy, using education and behavior modification alongside relaxation techniques, is better than routine care for relieving chronic pain. Learning to overcome mental stress and anxiety can be the key to coping with the physical limitations that may accompany long term conditions such as osteoarthritis. Cognitive therapy may include various techniques for activity scheduling, imaging, relaxation, mindfulness meditation, distraction and creative problem-solving.

Medication

Some studies suggest that glucosamine and chondroitin supplements are as effective as nonsterodial anti-inflammatory drugs (NSAIDS) reducing pain, swelling and stiffness in osteoarthritis. Studies have shown some promise that they may slow the progression of osteoarthritis as well. More studies are underway to further investigate this. Typical doses are 1,500 mg for glucosamine and 1,200 mg for chondroitin daily. Glucosamine can raise blood sugar, so be sure to talk to your doctor before taking it, especially if you have diabetes.

Cortical steroids

Another way of getting anti-inflammatory relief is through cortisone injections, or injections of certain types of steroids. Steroids are powerful anti-inflammatory agents and, when injected directly into an inflamed joint, can be very effective in reducing the pain and inflammation of the joint. Doctors try to limit the number of times a particular joint receives a cortisone injection within a period of time. Repeated and frequent injections of steroids into a joint can have significant side effects, such as thinning of the tissues and bones around the joint.

Acupuncture

The National Institutes of Health considers acupuncture an acceptable alternative treatment for osteoarthritis. Studies have shown that acupuncture helps reduce pain, may significantly lessen the need for painkillers and can help increase range of motion in affected joints.

Alternative and herbal remedies

Fish oil has been shown to reduce arthritis inflammation, lessen the need for painkillers and possibly decrease joint stiffness. A diet low in animal fats — including red meat and dairy products — may have similar effects. Excellent sources of fish oil include EPA/DHA capsules and oily fish such as salmon and mackerel.

At least a dozen different herbs have been used to ease the symptoms of joint inflammation; most are considered anti-inflammatories. Ask your doctor before you use any herbs because they can interact with each other or with medication you are taking. In many cases, lack of careful studies means little is known about long-term effects. Herbs that have been used for arthritis are powdered ginger, borage seed oil and devil's claw to reduce pain and swelling. Stinging nettles and turmeric also may lessen arthritis pain, stiffness and inflammation.

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